Vacation Bible School Registration Form

Vacation Bible School Online Registration Form
(Please submit one form for each child you are registering)

June 2-8, 2008
6:00 - 8:00 pm

First Church VBS is open to children 3 years of age to entering 5 th grade

SPECIAL NOTES: To print and fill out the form vice using the online one, Click Here!

If a parent cannot be reached in case of emergency, we MUST have an emergency contact person and phone number we can reach during the hours of VBS.

I hereby certify that the information given is correct. On the behalf of my child participant, I assume all risk of personal injury, damage and expense as the result of participation in the First Church VBS. I authorize staff to obtain proper medical diagnosis, hospitalization, secure proper treatment for, and to order injection, anesthesia, or surgery of my child attending First Church VBS.

This is for the protection of all of our important children.

Fill out information Here

Student's Name :

Telephone :

Home Church (if any):

Email :

Address :

City :

State :

Zip Code :

Age While attending VBS :

School grade for fall 2008 :

Birthday :

Parent/Guardian's Name:

Cell Phone :

Emergency Contact Name :

Emergency Contact Phone:

Physician’s Name :

Physician’s Phone:

Preferred Hospital :

By checking the box below, and signing this application when you come to chucrh, I hereby agree to the conditions of this form.
Yes: